The economic burden of disease of epithelial ovarian cancer in Spain: the OvarCost study

• Published in: The European journal of health economics Vol. 20; no. 1; pp. 135 - 147
• Main Authors: Delgado-Ortega, Laura, González-Domínguez, Almudena, Borrás, Josep María, Oliva-Moreno, Juan, González-Haba, Eva, Menjón, Salomón, Pérez, Pedro, Vicente, David, Cordero, Luis, Jiménez, Margarita, Simón, Susana, Hidalgo-Vega, Álvaro, Moya-Alarcón, Carlota
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer 01.02.2019; Springer Berlin Heidelberg; Springer Nature B.V
• Subjects: Aged; Carcinoma, Ovarian Epithelial - diagnosis; Carcinoma, Ovarian Epithelial - economics; Carcinoma, Ovarian Epithelial - therapy; Cost of Illness; Costs; Early Detection of Cancer - economics; Economic impact; Economic Policy; Economics; Epidemiology; Female; Genetic screening; Health care; Health Care Costs - statistics & numerical data; Health care expenditures; Health Care Management; Health Economics; Humans; Labor productivity; Markov analysis; Markov Chains; Medicine; Medicine & Public Health; Middle Aged; Original Paper; Ovarian cancer; Ovarian Neoplasms - diagnosis; Ovarian Neoplasms - economics; Ovarian Neoplasms - therapy; Patient Acceptance of Health Care - statistics & numerical data; Pharmacoeconomics and Health Outcomes; Public Finance; Public Health; Quality of life; Spain; Spain; Healthcare resource utilization; Economic burden of disease; Epithelial ovarian cancer; Spain
• ISSN: 1618-7598; 1618-7601; 1618-7601
• DOI: 10.1007/s10198-018-0986-y

Objective To assess the economic burden of epithelial ovarian cancer (EOC) in incident patients and the burden by disease stage in Spain. Methods We developed a Markov model from a social perspective simulating the natural history of EOC and its four stages, with a 10-year time horizon, 3-week cycles, 3% discount rate, and 2016 euros. Healthcare resource utilization and costs were estimated by disease stage. Direct healthcare costs (DHC) included early screening, genetic counselling, medical visits, diagnostic tests, surgery, chemotherapy, hospitalizations, emergency services, and palliative care. Direct non-healthcare costs permanent leaves, and premature death. Epidemiology data and resource use were taken from the literature and validated for Spain by the OvarCost group using a Delphi method. Results The total burden of EOC over 10 years was 3102 mill euros: 15.1% in stage I, 3.9% in stage II, 41.0% in stage III, and 40.2% in stage IV. Annual average cost/patient was €24,111 and it was €8,641; €14,184; €33,858, and €42,547 in stages I-IV, respectively. Of total cost, 71.2% were due to DHC, 24.7% to DNHC, and 4.1% to IC. Conclusions EOC imposes a significant economic burden on the national healthcare system and society in Spain. Investment in better early diagnosis techniques might increase survival and patients' quality of life. This would likely reduce costs derived from late stages, consequently leading to a substantial reduction of the economic burden associated with EOC.